血小板与淋巴细胞比值、中性粒细胞与淋巴细胞比值、癌胚抗原与直肠癌患者预后的关系

Relationship between platelet-to-lymphocyte ratio,neutrophil-to-lymphocyte ratio,carcinoembryonic antigen and prognosis of rectal cancer patients

目的探讨血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、癌胚抗原(CEA)与直肠癌患者预后的关系。方法选取60例直肠癌患者,随访3年,记录患者的预后情况。比较不同预后直肠癌患者PLR、NLR、CEA水平;直肠癌患者预后的影响因素采用多因素Logistic回归分析。结果随访3年,60例直肠癌患者生存32例,死亡28例。死亡直肠癌患者血清PLR、NLR、CEA水平均明显高于生存患者,差异均有统计学意义(P﹤0.01)。单因素分析结果显示,TNM分期为Ⅲ~Ⅳ期、分化程度为低分化、有淋巴结转移和有远处转移的直肠癌患者的生存率分别低于TNM分期为Ⅰ~Ⅱ期、分化程度为中高分化、无淋巴结转移以及无远处转移的患者,差异均有统计学意义(P﹤0.05)。多因素Logistic回归分析结果显示,TNM分期为Ⅲ~Ⅳ期、分化程度为低分化、有淋巴结转移、有远处转移、PLR升高、NLR升高、CEA升高均为直肠癌患者预后的独立危险因素(P﹤0.05)。结论外周血PLR、NLR以及CEA水平升高表明直肠癌患者死亡风险增加,临床工作中可通过联合检测上述指标为临床干预方案的制订提供指导依据,从而改善预后。

Objective To analyze the relationship between platelet-to-lymphocyte ratio(PLR),neutrophil-to-lympho-cyte ratio(NLR),carcinoembryonic antigen(CEA)and prognosis of patients with rectal cancer.Method A total of 60 patients with rectal cancer were selected and followed up for 3 years to record the prognosis.The PLR,NLR,and CEA in rectal cancer patients with different prognosis were compared.The influencing factors of prognosis in rectal cancer pa-tients were analyzed by multivariate Logistic regression.Result A total of 32 cases of 60 rectal cancer patients survived and 28 died after 3 years of follow up.The serum levels of PLR,NLR,and CEA in deceased rectal cancer patients were significantly higher than those in surviving patients(P<0.01).Univariate analysis showed that the survial rate of rectal cancer patients with TNM stage III-IV,poor differentiation,lymph node metastasis,and distant metastasis were lower than those with TNM stage I-II,medium and high differentiation,no lymph node metastasis,and no distant metastasis,re-spectively(P<0.05).Multivariate Logistic regression analysis showed that TNM stage III-IV,poor differentiation,lymph node metastasis,distant metastasis,elevated PLR,NLR,and CEA were independent risk factors for the prognosis of rec-tal cancer patients(P<0.05).Conclusion The elevated levels of peripheral blood PLR,NLR and CEA indicate the in-creased risk of death in patients with rectal cancer.In clinical practice,the above indicators can be jointly detected to pro-vide guidance for the formulation of clinical intervention to improve the prognosis.